Provider Demographics
NPI:1467542191
Name:MONASTYRSKYJ, OLA A (MD)
Entity Type:Individual
Prefix:DR
First Name:OLA
Middle Name:A
Last Name:MONASTYRSKYJ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 95000 LB# 7550
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-7550
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:95 MADISON AVE
Practice Address - Street 2:SUITE A00
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960
Practice Address - Country:US
Practice Address - Phone:973-538-1388
Practice Address - Fax:973-538-9501
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA62918207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7514905Medicaid
F29398Medicare UPIN
NJ7514905Medicaid